Motivational Interviewing as Evidence-Based Practice? An Example from Sexual Risk Reduction Interventions Targeting Adolescents and Young Adults

Bahner, Julia; Stenqvist, Karin

doi:10.1007/s13178-019-00388-y

Cited by 55 publications

(4 citation statements)

References 68 publications

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“…Tying HIV education to the broader goals and values of men is critical to helping men identify how HIV treatment can specifically benefit their lives, and therefore, increases individual buy-in and commitment to treatment [55,[73][74][75][76][77]. We found that motivating explanations were usually provided "sometimes" not "often."…”

Section: Discussionmentioning

confidence: 91%

Implementing a male‐specific ART counselling curriculum: a quality assessment with healthcare workers in Malawi

Robson,

Mphande,

Lee

et al. 2024

J Int AIDS Soc.

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IntroductionThere is little HIV counselling that directly meets the needs of men in Eastern and Southern Africa, limiting men's knowledge about the benefits of HIV treatment and how to overcome barriers to engagement, contributing to poorer HIV‐related outcomes than women. Male‐specific approaches are needed to improve men's outcomes but may be difficult for healthcare workers (HCWs) to implement with fidelity and quality in low‐resource settings. We developed a male‐specific counselling curriculum which was implemented by male HCWs and then conducted a mixed‐methods quality assessment.MethodsWe audio‐recorded counselling sessions to assess the quality of implementation (n = 50) by male HCWs from two cadres (nurse, n = 10 and lay cadre, n = 10) and conducted focus group discussions (FGDs) with HCWs at 6 and 9 months after rollout to understand barriers and facilitators to implementation. Counselling sessions and FGDs were translated, transcribed and analysed using thematic analysis adapted from WHO Quality Counselling Guidelines. We assessed if sessions were respectful, informative, interactive, motivating and included tailored action plans for overcoming barriers to care. All data were collected September 2021−June 2022.ResultsAll sessions used respectful, non‐judgemental language. Sessions were highly interactive with most HCWs frequently asking open‐ended questions (n = 46, 92%) and often incorporating motivational explanations of how antiretroviral therapy contributes to life goals (n = 42, 84%). Few sessions included individually tailored action plans for clients to overcome barriers to care (n = 9, 18%). New counselling themes were well covered; however, occasionally themes of self‐compassion and safe sex were not covered during sessions (n = 16 and n = 11). HCWs believed that having male HCWs conduct counselling, ongoing professional development and keeping detailed counselling notes facilitated quality implementation. Perceived barriers included curriculum length and client hesitancy to participate in action plan development. Findings were similar across cadres.ConclusionsImplementing high‐quality male‐specific counselling using male nurses and/or lay cadre is feasible. Efforts to utilize lay cadres should be prioritized, particularly in low‐resource settings. Programmes should provide comprehensive job aids to support HCWs. Ongoing training and professional development are needed to (1) improve HCWs’ skills in tailored action plans, and (2) sensitize HCWs to the need for self‐compassion within male clients to promote holistic sexual health.

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Section: Discussionmentioning

confidence: 91%

Implementing a male‐specific ART counselling curriculum: a quality assessment with healthcare workers in Malawi

Robson,

Mphande,

Lee

et al. 2024

J Int AIDS Soc.

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“…When considering sexual health speci cally, it is likely that re ecting on the personal relevance of one's sexual wellbeing will increase motivation to change. Using motivational interviewing techniques is one evidence-based way of achieving this shift [23,24]. The model suggests that an intervention in this area should therefore focus on the following: Information (education) about the issues to improve knowledge of sexual wellbeing (e.g., HIV, STIs, contraception, risk behaviours, and what respectful, safe relationships should look like); Motivation, such as weighing up the pros and cons of contraception, mediating risk perception, and issues around consent;…”

Section: Identifying Theorymentioning

confidence: 99%

The development of a novel sexual health promotion intervention for young people with mental ill-health: the PROSPEct project.

Nolan

O’Donoghue

Simmons

et al. 2023

Preprint

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Background Young people with mental ill-health have higher rates of high-risk sexual behaviour, poorer sexual health outcomes, and lower satisfaction with their sexual wellbeing compared to their peers. Ensuring good sexual health in this cohort is a public health concern, but best practice intervention in the area remains under-researched. The study aimed to co-produce a novel intervention to address the sexual health needs of young people with mental ill-health to test its effectiveness in a future trial. Methods We followed the 2022 Medical Research Council (MRC) guidelines for developing and evaluating complex interventions. This involved synthesising evidence from the 'top down' (published evidence) and 'bottom up' (stakeholder views). We combined systematic review findings with data elicited from qualitative interviews and focus groups with young people, carers, and clinicians and identified critical cultural issues. Results Existing evidence in the field of sexual health in youth mental health was limited but suggested the need to address sexual wellbeing as a concept broader than an absence of negative health outcomes. The Information-Motivation-Belief model was chosen as the theoretical Framework on which to base the intervention. Interviews/focus groups were conducted with 29 stakeholders (18 clinicians, three carers, and eight young people). Synthesis of the evidence gathered resulted in the co-design of a novel intervention consisting of an initial consultation and four 60-90-minute sessions delivered individually by a clinician with additional training in sexual health. Barriers and supports to intervention success were also identified. Conclusions Using the MRC Framework has guided the co-development of a potentially promising intervention that addresses the sexual health needs of young people with mental ill-health. The next step is to test the intervention in a one-arm feasibility trial.

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“…Here, too, it is possible to apply the whole RSH interview (when preferred, in an adjusted form), or certain parts of it for treatments in sexology or relationship therapy. The RSH interview method can also be combined with principles of Motivational Interviewing (MI), by integrating it with the process of formulating an improvement plan toward healthy and pleasurable intimate relationships and sexuality of young adults (Bahner and Stenqvist, 2020). Furthermore, using the RSH interview method can increase cross-pollination between these clinical fields, by paying more attention to relational context of sexological problems, and by paying more attention to the role of sexuality in (causing or solving) relationship problems.…”

Section: Clinical Applicabilitymentioning

confidence: 99%

New Interview Method for Sketching the Dynamic Relational and Sexual History of Young Adults

Bongardt

Verbeek

2021

Sex Res Soc Policy

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Introduction Scientific literature and clinical practice still pay insufficient attention to the interconnectedness between love and sex. Especially youth would benefit in their sexual development from more attention (e.g., in parenting, education, sexual health services) for the complex relational context of sexual decisions and interactions. Methods To gain more insight into young people’s dynamically intertwined early experiences with romantic relationships and sexuality, a new semi-structured interview method was developed as part of a larger study on the interrelatedness of love and sex (“Lovely sex or sexy love?”). The newly developed Relational and Sexual History (RSH) interview consists of five steps and is visually supported by a relationship matrix to sketch how developments in relational and sexual aspects of early intimate relationships (from adolescence to young adulthood) are interrelated, and how youth learn cumulatively (across their relationships) about what they do and do not want in their intimate partnerships. Results The RSH interview method was piloted in 2018 in a small-scale qualitative study with N = 16 young adults (9 women, 7 men; 18‒25 years). This pilot study showed the method is suitable to assess the chronologic, dynamic, and intertwined relational and sexual histories of youth in a semi-structured manner. Conclusions and Policy Implications The RSH interview method may advance scientific research on the linkages between love and sex and can be a valuable tool for clinical practice in sexology and relationship therapy (and increase cross-pollination between these clinical fields). The type of knowledge yielded by these interviews may profoundly impact policies for relational and sexual health promotion for youth.

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Motivational Interviewing as Evidence-Based Practice? An Example from Sexual Risk Reduction Interventions Targeting Adolescents and Young Adults

Cited by 55 publications

References 68 publications

Implementing a male‐specific ART counselling curriculum: a quality assessment with healthcare workers in Malawi

Implementing a male‐specific ART counselling curriculum: a quality assessment with healthcare workers in Malawi

The development of a novel sexual health promotion intervention for young people with mental ill-health: the PROSPEct project.

New Interview Method for Sketching the Dynamic Relational and Sexual History of Young Adults

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